单开门椎管扩大成形术脊髓后移距离与临床疗效相关性研究

Correlation study of shift of spinal cord and clinical result after posterior decompression

目的探讨单开门椎管扩大成形术后脊髓后移距离与临床疗效关系。方法对47例单开门椎体扩大成形术患者JOA评分评估术前及术后3个月脊髓功能。在MRI T2加权像正中央矢状面测量脊髓后移距离。以脊髓后移距离0~3 mm为B组,≥3.0 mm为A组,两组间年龄、病程、术前JOA评分、T2像高信号及压迫节段内最大致压直径行均衡性检验,比较两组JOA评分改善率及优良率,分析脊髓后移距离与疗效行相关性。结果两组上述因素统计学上无显著性差异（P〉0.05）,A B组术后JOA评分改善率及优良率均有显著性差异（P〈0.01）。脊髓后移距离与JOA评分改善率相关分析（r=0.667,P=0.000）,认为脊两者间存在正线性相关。结论单开门椎管扩大成形术后减压节段内脊髓平均后移距离大于3 mm时脊髓功能恢复较好。

Objective To investigate the relationship between the posterior shift of spinal cord and clinical effect after single open door laminoplasty in the patients with cervical spondylotic myelopathy.Methods The spinal cord function of 47 patients who underwent single open door laminoplasty were evaluated by Japanese orthopaedic society（JOA） rating criteria in the preoperative and postoperative 3 months.The distance of posterior spinal cord migration was measured in MRI imaging T2-weighted images on central sagittal,0-3mm for group B and ≥3 mm for group A.The age,duration,preoperative JOA score,compression diameter of the largest segment between two groups were assessed with balancing test.The recovery rate and good rate of JOA score were compared between the two groups,the relationship between posterior shift of spinal cord and the curative effect was analyzed.Results There were no statistically significant differences between the two groups in age,disease duration,preoperative JOA score,T2 high signal and compression diameter of the largest segment caused by two sample T test diamete（r P＆gt;0.05）.After operation,the recovery rate and excellent good rate of JOA score between the two groups had significant differences（P＆lt;0.01）.The posterior shift of spinal cord was positively correlated wih JOA score recovery rate（r=0.667 P=0.000）.Conclusion Decompression segment within an average of spinal cord drift more than 3 mm after single open door laminoplasty the spinal cord function recovered well.